<?xml version="1.0" encoding="UTF-8"?>
<content version="1.0.0.20070416">
	<shopcart name="Shopcart" type="shop_cart_display"/>
	<page>
		<fields button="custom" buttonlabel="Make Payment" type="checkout" name="aForm"  >
			<action url="https://backoffice.iveri.co.za/Lite/Authorise.asp"/>
			<validation/>
			<fld type="fld_hidden"  name="Lite_Merchant_ApplicationId">
				<value>0187CDAD-ED85-42CD-8D15-93D50035904A</value>
			</fld>
			<fld type="fld_hidden" name="Lite_Order_Amount">
				buttonstyle="rel" oneclick="yes"
				<value/>
			</fld>
			<fld type="fld_hidden" name="Lite_Order_Terminal">
				<value>Web</value>
			</fld>
			<fld type="fld_hidden" name="Lite_Order_AuthorisationCode">
				<value/>
			</fld>
			<fld type="fld_hidden" name="Lite_Order_BudgetPeriod">
				<value>0</value>
			</fld>
			<fld type="fld_hidden" name="Lite_Website_TextColor">
				<value>#ffffff</value>
			</fld>
			<fld type="fld_hidden" name="Lite_Website_BGColor">
				<value>#86001B</value>
			</fld>
			<fld type="fld_hidden" name="Lite_ConsumerOrderID_PreFix">
				<value>LLP</value>
			</fld>
			<fld type="fld_hidden" name="Ecom_ConsumerOrderID">
				<value>AUTOGENERATE</value>
			</fld>
			<fld type="fld_hidden" name="Lite_Authorisation">
				<value>false</value>
			</fld>
			<fld type="fld_hidden" name="Lite_On_Error_Resume_Next">
				<value>true</value>
			</fld>
			<!-- this needs to change possibly with a broker -->
			<fld type="fld_hidden" name="Lite_Order_LineItems_Product_1">
				<value>LifeLine Donation Pledge#1</value>
			</fld>
			<fld type="fld_hidden" name="Lite_Order_LineItems_Quantity_1">
				<value>1</value>
			</fld>
			<!-- till here -->

			<!--End Iveri info-->
			<fld type="fld_hidden" NAME="Lite_Website_Successful_url">
				<value>/default.aspx?link=online_donations_thanks</value>
			</fld>
			<fld type="fld_hidden" NAME="Lite_Website_Fail_url">
				<value>/default.aspx?link=online_donations_internal_error</value>
			</fld>
			<fld type="fld_hidden" NAME="Lite_Website_TryLater_url">
				<value>/default.aspx?link=online_donations_unknown_error</value>
			</fld>
			<fld type="fld_hidden" NAME="Lite_Website_Error_url">
				<value>/default.aspx?link=online_donations_website_error</value>
			</fld>

			<label name="CCdetailslabel" formsplit="yes">Your Credit Card details</label>
			<fld name="Ecom_Payment_Card_Type" type="fld_drop">
				<prompt>Card Type</prompt>
				<hintnormal/>
				<hintvalid>Please select your credit card type</hintvalid>
				<mandatory>Y</mandatory>
				<subobjs>
					<subwf_obj>
						<prompt>Please select...</prompt>
						<value>0</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>Master Card</prompt>
						<value>MAST</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>VISA</prompt>
						<value>VISA</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>American Express</prompt>
						<value>AMER</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>Diners Club</prompt>
						<value>DINE</value>
					</subwf_obj>
				</subobjs>
				<valid>validDrop</valid>
				<value/>
			</fld>
			<fld name="Ecom_Payment_Card_Name" type="fld_input">
				<prompt>Cardholders Name</prompt>
				<hintnormal>As it appears on the credit card</hintnormal>
				<hintvalid>Please enter the name on your credit card</hintvalid>
				<mandatory>Y</mandatory>
				<valid>validText</valid>
				<value/>
			</fld>
			<fld name="Ecom_Payment_Card_Number" type="fld_input">
				<prompt>Credit Card Number</prompt>
				<hintnormal></hintnormal>
				<hintvalid>Please enter your credit card number</hintvalid>
				<mandatory>Y</mandatory>
				<valid>validText</valid>
				<value/>
			</fld>
			<fld name="Ecom_Payment_Card_Verification" type="fld_input">
				<prompt>Card verification number</prompt>
				<hintnormal></hintnormal>
				<hintvalid>Dont forget to enter the 3 digit verification number found on the back of your credit card</hintvalid>
				<mandatory>Y</mandatory>
				<valid>validText</valid>
				<value/>
			</fld>
			<fld type="fld_hidden"  name="Ecom_Payment_Card_StartDate_Day">
				<value>00</value>
			</fld>
			<fld type="fld_hidden"  name="Ecom_Payment_Card_StartDate_Month">
				<value>07</value>
			</fld>
			<fld type="fld_hidden"  name="Ecom_Payment_Card_StartDate_Year">
				<value>2004</value>
			</fld>
			<fld type="fld_drop"  name="Ecom_Payment_Card_ExpDate_Month">
				<prompt>Expiry Month</prompt>
				<hintnormal></hintnormal>
				<hintvalid>Please select the month in which your credit card expires</hintvalid>
				<subobjs>
					<subwf_obj>
						<prompt>Please select...</prompt>
						<value>0</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>January</prompt>
						<value>01</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>February</prompt>
						<value>02</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>March</prompt>
						<value>03</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>April</prompt>
						<value>04</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>May</prompt>
						<value>05</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>June</prompt>
						<value>06</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>July</prompt>
						<value>07</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>August</prompt>
						<value>08</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>September</prompt>
						<value>09</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>October</prompt>
						<value>10</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>November</prompt>
						<value>11</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>December</prompt>
						<value>12</value>
					</subwf_obj>
				</subobjs>
				<mandatory>Y</mandatory>
				<valid>validDrop</valid>
			</fld>
			<fld type="fld_drop" name="Ecom_Payment_Card_ExpDate_Year">
				<prompt>Expiry Year</prompt>
				<hintnormal></hintnormal>
				<hintvalid>Dont forget to select your credit card expiry date year</hintvalid>
				<subobjs>
					<subwf_obj>
						<prompt>Please select...</prompt>
						<value>0</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>2006</prompt>
						<value>2006</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>2007</prompt>
						<value>2007</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>2008</prompt>
						<value>2008</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>2009</prompt>
						<value>2009</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>2010</prompt>
						<value>2010</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>2011</prompt>
						<value>2011</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>2012</prompt>
						<value>2012</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>2013</prompt>
						<value>2013</value>
					</subwf_obj>
					<subwf_obj>
						<prompt>2014</prompt>
						<value>2005</value>
					</subwf_obj>
				</subobjs>
				<mandatory>Y</mandatory>
				<valid>validDrop</valid>
			</fld>
			<fld type="fld_hidden" name="Ecom_Payment_Card_Protocols">
				<value>IVERI</value>
			</fld>
			<fld type="fld_hidden" name="Ecom_SchemaVersion">
				<value/>
			</fld>
			<fld type="fld_hidden" name="Ecom_TransactionComplete">
				<value>FALSE</value>
			</fld>
			<fld type="fld_hidden" name="Lite_Version ">
				<value>2.0</value>
			</fld>
		</fields>
	</page>
</content>
